Add yet another wrinkle to the convoluted mathematics of the Patient Protection and Affordable Care Act: repayments for health premium subsidies received by those deemed to be ineligible for them.
Under terms of the act, persons earning up to four times the federal poverty level ($46,680) are eligible for subsidies. But determining exactly who was eligible to receive such federal subsidies was an inexact process at best. Consider:
- Many were asked to estimate their annual income, with little supporting documentation required. Result: Some may have made more than the ceiling for subsidies.
- Immigrants at or below the subsidy level had to submit proof of residency status. But thousands have had trouble doing so, partly due to federal insurance website glitches.
- People employed by a company offering coverage who opted to get coverage from a state or federal exchange now will be asked to prove "looking backward" that they were eligible.
Soon will come the time for all those found to be ineligible for subsidies to repay the government. To add to the potential for another bureaucratic nightmare, the feds will be requiring different levels of repayment from different categories of recipients, according to an article in Kaiser Health News.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
